Practice

Request for slimming tablets

BMJ 2008; 337 doi: http://dx.doi.org/10.1136/bmj.a1287 (Published 24 October 2008) Cite this as: BMJ 2008;337:a1287

This article has a correction. Please see:

  1. S W Mercer, professor of primary care research1,
  2. M E J Lean, professor of human nutrition2
  1. 1General Practice and Primary Care, Division of Community-based Sciences, Faculty of Medicine, University of Glasgow, Glasgow G12 9LX
  2. 2Human Nutrition, Division of Developmental Medicine, Faculty of Medicine, University of Glasgow
  1. Correspondence to: S Mercer s.mercer{at}clinmed.gla.ac.uk
  • Accepted 31 May 2007

A 43 year old hairdresser who has recently moved into the area after a divorce asks you for slimming pills. Medical records from her previous GP shows that she rarely consults doctors.

What issues you should cover

Optimal management of obesity combines diet, exercise, lifestyle advice, and, where necessary, pharmacotherapy and surgery. Current drugs used in weight management are not the “slimming pills” used many years ago. However, they are all expensive and should be used rationally within structured management programmes. Shared care between the GP and a practice nurse trained in weight management may make the management of obesity in primary care more feasible.

Explore the request in a non-judgmental way

Whether the patient looks overweight or not, find out why she is requesting the pills. Often patients will present because of an impending social or personal event (a wedding or holiday). What exactly does she know about slimming tablets? Where did the information come from? What does she expect from them? Has she ever taken them in the past and, if so, who prescribed them? Has she taken any recently?

Take a history

Take a detailed history of her weight and weight gain. …

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